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  • Autopsy Question (recovered)

    Elias4th June 2006, 12:27 PM
    Hi all,

    I was reading, well, more trying to decrypt it really, the autopsy report of Eddowes and came upon the following:

    "The sigmoid flexure was invaginated into the rectum very tightly." (from The mammoth book of JtR, page 80).

    Well, the "sigmoid flexure" is, according to what I found on the web, "the s-shaped curve between the descending colon and the rectum" and "invaginated" means "fold inwards".

    So my question, and I don't really know anything about the jarong of coroners, is - could this be said to suggest anal "connexion"? If not, well, then what does it mean and how does it happen?

    All the best,

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    JMenges4th June 2006, 01:20 PM
    Hi.

    I'm no doctor, but I do have Google (so I may be wrong), but from what I read it sounds as though an "invaginated sigmoid flexure" that clogs up the rectum is what, in some cases, causes constipation. It's a condition called intussusception that can be acute or chronic and bother the sufferer on and off for years. A poor diet, like eating too much oats, could lead to this. I'd say that the discovery of this condition in Eddowes does not evidence "anal connexion", just that she was having certain personal problems with her bowels at the time of her death.

    I won't speculate on whether this problem would have caused feces build up in her intestines, or how that may relate to the material found on the piece of apron, because sometimes the re-dissection of these poor women by us posters makes me uncomfortable. Not constipated-uncomfortable, but just uncomfortable.

    Here is a link I read concerning intestinal obstruction

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    JM

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    garyw4th June 2006, 01:41 PM
    HI Elias


    I've wondered about this myself and taken it to mean that the point at which the colon and rectum meet were in spasm at the time of death. I'm probably wrong and I would love to get a clearer explanation.

    The article JM sites mentions Sir F. Treves of Elephant Man fame. Poor Kate may have suffered from Irritable bowel syndrome.

    All The Best
    Gary

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    JMenges4th June 2006, 01:47 PM
    In all the medical lingo from the above link, I pull out this relevant quote.

    "Faecal Impaction is not uncommon in adult females who have suffered from chronic constipation. The common seat of the block-age is in the
    colon, chiefly in the sigmoid flexure and in the rectum, but it may occur in the caecum. The accumulation may form a doughy tumour which in parts may be nodular and intensely hard. The causes are due to the state of the contents of the bowel itself, to congenital or acquired weakness and diminished expulsive power of the bowel, or to painful affections of the anus, fissures, piles and painful bladder affections. The acute symptoms are always pre-ceded by a prolonged period of malaise; the breath is offensive and the tongue foul, and the temperature may be raised from the absorption of toxins."

    JM

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    Sam Flynn4th June 2006, 02:05 PM
    I've wondered about this myself and taken it to mean that the point at which the colon and rectum meet were in spasm at the time of death.
    That's how I'd always read it too, Gary. The words "invaginated into the rectum very tightly" seems to suggest a spasm, possibly caused by a contraction of the muscles at the point when Jack severed the colon. The autonomic nervous system continues to function for quite some time after death, and the reflexive contraction of muscles - such as those lining the bowel - is certainly possible.

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    Elias4th June 2006, 02:59 PM
    Hi JM, Gary and Sam,

    Thanks alot for the info, and thanks for not making me feel like an idiot or pervert in asking the question! It's an interesting thing in that it kind of stands out when you read the report. Following your information, JM, I guess it's not so strange that the intestines, and the Rippers hands/and apron, were smeared with feaces? As for the spasm, or cramp?, could it be the result of something like rape or insertion of an object into the rectum?

    Thanks again,

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    Mr Poster4th June 2006, 03:17 PM
    Hody Sam F.

    NOt being trivial here...but do the bowels and bladder not relax upon the moment of death? Leading to the jokes about the poor mans seats being under the gallows and not beside it?

    Hello Elias

    The Rippers possible predilictions regarding what was going on with his victims and indeed how prostitutes avoided pregnancy has been metioned on another thread but for the life of me I dont know the name of it.


    p

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    Elias4th June 2006, 03:32 PM
    Hi Mr P, thanks for your reply. I'm sure almost anything I can think of already has been posted on the old board! But maybe we should have a section of the board for questions regarding the autopsies? There's a lot of terms in them that are unfamiliar to me, and, I'm sure, to others as well.

    The reason I asked about the "anal connexion" is that if it really happened it may tell us something important about the killer. More so if he didn't ejaculate.

    All the best,

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    Mr Poster4th June 2006, 03:39 PM
    Hello Elias

    The lack of "spend" or traces of "connection" is often used to suggest that such connection didn occur but I have never been fully convinced that some sort of activity wasnt going on.

    Prostitutes who didnt want to lie on the ground, stood facing the wall back to the Ripper, no connection traces.......the Victorian reluctance to perhaps discuss or mention anything a little "odd" if you know what I mean....

    I just wouldnt rule out connection absolutely. Just perhaps use a broader brush to define it.

    p

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    Elias4th June 2006, 03:46 PM
    That's a very good point, Mr P, and I also think to much's been made of the "no connexion"-remark in the autopsy reports. The doctors seem to have thought that the "connexions" were done with the women lying on the ground, for gods sake!

    I will read on and post additional questions here!

    It would be good, albeit a bit grisly, to have a computer generated image of the wounds of the different victims done. It's quite hard to picture all the damages in ones minds eye.

    All the best,

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    Sam Flynn4th June 2006, 06:16 PM
    Hody Sam F.

    NOt being trivial here...but do the bowels and bladder not relax upon the moment of death? Leading to the jokes about the poor mans seats being under the gallows and not beside it?
    Indeed, although the "relaxation" of a muscle depends pretty much on its relaxed state, if that doesn't sound obtuse - i.e. "relaxed" doesn't necessarily mean "loose". And even a "loose" muscle can be stimulated to contract even after brain-death, because the autonomic nervous system continues to work for a while.

    Thanks for the gallows humour - never heard that one before! You're right about that, of course. However, defecation after death happens partly because peristalsis (waves of muscular contraction/relaxation along the gut) continues, not simply because the anal sphincter and descending colon open up like an escape chute.

    Having worked on a poultry farm, I've had to wipe quite a number of birds' bottoms hours after death - for cosmetic purposes, believe it or not. If we didn't, some butchers would ask for a discount when we delivered the birds to them! (Too much detail, I know )

    In Eddowes' case, the severance of the colon just above the sigmoid flexure could have caused a reflexive contraction of the muscle, which I believe may have caused it to retract into the rectum. But then, I am not a proctologist and I could be hopelessly wrong

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    diana4th June 2006, 07:09 PM
    I believe that what is described here is intussusception. I had a pathology course last semester. If you imagine removing a garment with tight long sleeves, you know that sometimes as you take it off the wrist-end of the sleeve will be drawn up inside the forearm.

    This link describes intussusception and points out that only 5-16% of intussusceptions are in adults. It is basically a problem of early childhood.

    http://www.emedmag.com/html/pre/gic/consults/111504.asp (http://www.emedmag.com/html/pre/gic/consults/111504.asp)

    Here is an image of an intussusception. This pic has the intussusception at the other end of the colon from where Kate had it (the cecum end where the small intestine and appendix attach). But it gives you the idea.

    http://www.yoursurgery.com/Procedure...m?BR=1&Proc=81 (http://www.yoursurgery.com/Procedure...m?BR=1&Proc=81)

    Scroll down about halfway.

    Since intussusceptions usually happen in kids and cause excruciating pain I’m inclined to think this one was caused by something the Ripper did.

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    Elias10th June 2006, 08:55 AM
    Hi Diana, and thanks for your post. What could the ripper have done to cause this, in your mind? The link provided me with these causes:


    Nonidiopathic causes can be attributed to polyps, lipomas, Meckel's diverticulum, intestinal duplication, Henoch-Schönlein purpura, lymphomas, hypertrophied Peyer patches secondary to infection, adenovirus infection, foreign bodies, parasitic infestations, celiac disease, and cystic fibrosis.


    Foreign bodies above, what does that mean? Would the insertion of something count as a foreign body?

    All the best,

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    Sam Flynn10th June 2006, 09:56 AM
    Hi Diana, and thanks for your post. What could the ripper have done to cause this, in your mind? The link provided me with these causes:

    Foreign bodies above, what does that mean? Would the insertion of something count as a foreign body?
    Elias,

    I see no need to propose any insertion of a foreign body - apart from a knife! The colon was cut through above the sigmoid flexure and probably just "collapsed" (possibly due to a reflexive muscle spasm) into the rectum of its own accord.

    Now this sounds a little yucky, but if you've ever cut through an earthworm with a spade, the edges of the wound (on both halves of the worm) have a "rounded" appearance, due to the worm's muscles curling inwards. Imagine the same effect but on a grander scale with Eddowes' colon and I don't think we're far off what may have happened.

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    Elias10th June 2006, 11:16 AM
    Hi Sam,

    thanks alot for that information, yucky as it might be! I now feel much more knowledgeable in the area of colon trauma, and that is a glorious feeling.

    No, seriously, it's good to know more about the injures that the victims suffered, and I really think this board should have a section for autopsy protocols and such.

    I will continue to read the autopsy reports and will be sure to ask if anything is hard to follow. I'm sure I'm not the only one who is less than an expert when it comes to these things.

    All the best, and thanks again,

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    diana10th June 2006, 09:04 PM
    One website says that an intussusception, if left untreated leads to death in three to five days.

    However I don't think Eddowes would have been kidding around with the jailor or imitating a fire engine if she had one. She would have been in great pain. Well come to think of it some websites say the pain can be intermittent.

    I tend to want to look for commonalities. Wasn't Chapman on her way downhill healthwise? And if Maxwell is to be believed Kelly threw up. Hmm where would we go with that?

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    Sam Flynn10th June 2006, 09:28 PM
    I tend to want to look for commonalities. Wasn't Chapman on her way downhill healthwise? And if Maxwell is to be believed Kelly threw up. Hmm where would we go with that?
    Er... Jack had X-ray eyes?

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